If you are applying for a green card from inside the United States, you may need Form I-693, also called the Report of Medical Examination and Vaccination Record. This form documents an immigration medical exam and required vaccination information. It is completed by an approved doctor and is used to address health-related admissibility requirements.

The process can feel unfamiliar, especially if English is not your first language. The good news is that you can prepare by understanding who can perform the exam, what to bring, what happens during the appointment, and how to submit the completed form correctly.

What Form I-693 Is

Form I-693 is part of the green card process for many people applying in the United States. It is not a regular medical checkup with your usual doctor unless that doctor is approved for immigration medical exams.

The form includes the results of a medical examination and a review of your vaccination record. Its purpose is to show whether there are health-related reasons that could affect eligibility to receive a green card.

This requirement applies to applicants seeking adjustment of status in the United States. If you are applying for an immigrant visa outside the United States through a U.S. consulate, the document explains that you do not use Form I-693. Instead, you have a medical examination with a Department of State panel physician.

Choose an Approved Civil Surgeon

Only a doctor approved by USCIS, called a civil surgeon, can complete Form I-693 for a green card application filed in the United States.

Before you schedule an appointment, confirm that the doctor is listed by USCIS as a civil surgeon. When you call the office, clearly say that you need an immigration medical examination for Form I-693. This can help the office schedule the correct type of appointment and tell you what records to bring.

The cost is not the same at every office. The document notes that fees vary by physician, so it may be helpful to compare costs before choosing where to go.

How to Prepare for the Appointment

Gather your records before your appointment. Being organized can help prevent delays or the need for additional follow-up.

The document recommends bringing:

• Government-issued photo identification
• A list of medications you are currently taking
• Your vaccination records
• Proof of COVID-19 vaccination, if applicable
• Other medical records, if available
• A current edition of Form I-693

If you do not have every record, do not assume that the process cannot move forward. Bring the information you do have and ask the civil surgeon’s office what may be needed. The medical provider may determine that additional testing is necessary.

What Happens During the Medical Exam

At the beginning of the appointment, you will sign a certification confirming that you agree to the exam and that the information you provide is true.

During the exam, the civil surgeon reviews the areas required for immigration purposes. According to the document, this includes testing for certain communicable diseases that are important to public health. The doctor also screens for certain physical or mental disorders and for drug addiction or abuse.

The civil surgeon will review whether you have the vaccinations required for the immigration medical exam. Additional testing may be needed depending on the information reviewed during your appointment.

It is important to answer questions honestly and provide accurate medical and vaccination information. If you are unsure about a medication, vaccine, or past medical record, bring what you have and ask the provider for guidance.

Protect the Sealed Envelope

After the required testing is complete, the civil surgeon signs Form I-693 and places it in a sealed envelope. This envelope is extremely important.

Do not open it, break the seal, or change the envelope in any way. USCIS will not accept the form if the envelope is unsealed or altered. Ask the civil surgeon for an additional copy of the signed form for your own records, but keep the original sealed envelope safe for submission to USCIS.

A simple mistake with the envelope can create an avoidable problem. Keep it in a secure place and follow the filing instructions for your green card application.

Submit the Medical Exam With Your Green Card Application

The update explains that, as of December 2, 2024, applicants must submit the completed medical exam with their green card application. If the medical exam is not submitted with Form I-485, USCIS may reject the green card application.

This makes timing important. Do not wait until the last minute to schedule the medical exam, collect vaccination records, or obtain the sealed Form I-693. Planning ahead can help you file a more complete application package.

How Long Form I-693 Is Valid

The date when the civil surgeon signs the form matters. A Form I-693 properly completed and signed on or after November 1, 2023 does not expire, according to the update. A form completed before that date is valid for two years from the civil surgeon’s signature date.

However, the document also explains that USCIS may request more evidence or a new or updated Form I-693 if an officer has reason to believe a person’s medical condition has changed or the form no longer accurately reflects that person’s condition.

FAQ

Do I need Form I-693 if I am applying for a green card from outside the United States?

No. The update explains that applicants using consular processing abroad receive a medical exam from a Department of State panel physician instead.

Can my family doctor complete Form I-693?

Only if your doctor is listed by USCIS as an approved civil surgeon. Confirm this before scheduling the exam.

Should I open the sealed Form I-693 envelope to check it?

No. Do not open or alter the sealed envelope. USCIS may not accept it if the seal is broken or changed.

What if I cannot find all of my vaccination records?

Bring the records you have and discuss your situation with the civil surgeon’s office. The provider may advise you about what additional information or testing is needed.

Does a Form I-693 signed after November 1, 2023 expire?

The update states that a properly completed Form I-693 signed by a civil surgeon on or after November 1, 2023 does not expire. USCIS may still request updated evidence in certain circumstances described above.

Immigration forms and filing requirements can have serious consequences if they are incomplete or submitted incorrectly. If this update affects a pending or planned green card matter, contact Ventresca & Ventresca LLP to discuss your situation and next steps.